Pericardial recesses

Last revised by Assoc Prof Craig Hacking on 12 May 2022

The pericardial recesses are small spaces in the pericardial cavity formed by reflections of the pericardium.

Gross anatomy

Pericardial fluid can pool in these recesses and can be categorized by whether they arise from the transverse sinus, the oblique sinus, or the pericardial cavity proper 3:

Differential diagnosis

Pooled pericardial fluid can mimic:

  • mediastinal lymph nodes: tend to be round/oval and soft tissue attention compared to pericardial recesses, which tend to be crescentic-shaped curving around vascular structures and fluid attenuation in recognized locations 3
  • aortic dissection 3
  • bronchogenic cyst 3

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Cases and figures

  • Case 1: superior aortic recess
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  • Case 2: superior aortic recess
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